1. Dialogical Work in Mental Health and the Open Dialogue Approach
By Dagmar Narusson PhD
Dialogical work in mental health is rooted in the principles of the Open Dialogue (OD) approach, which emerged from systemic and network therapies, need-adapted treatment, and Bakhtin’s concept of dialogism. Contrary to common belief, ‘dialogue’ originally means “understanding through words,” not just conversation between people. OD focuses on meeting the unique needs of individuals and their families through open treatment meetings that draw on the patient’s own psychological resources. While its principles often resonate deeply with practitioners, applying them in practice can be challenging due to contradictions with existing health systems and the need to retrain or “unlearn” established methods. As a practical step, CARe practitioners can gradually incorporate OD principles into their daily work without formal training, a process referred to as dialogical work in mental health.
2. Experiential Knowledge and Experiential Expertise – Not the Same
By Alie Weerman
The CARe model emphasizes supportive-relational-acting, where the relationship between the care professional and the client is a vital tool. Good care involves ongoing, responsive interaction, grounded in equality and reciprocity. Reciprocity goes beyond equality by encouraging mutual sharing of experiences. Because clients often struggle to express complex or painful experiences verbally, care professionals must create space for alternative expressions, like drawing.
Importantly, reciprocity includes the professional’s own sharing, introducing a personal-professional dimension. While traditionally discouraged, professionals are now increasingly recognizing and using their own lived experiences—such as trauma and recovery—as valuable experiential knowledge. This shift supports more authentic, dynamic relationships but also introduces new challenges, which are further explored in the context of Dutch developments in experiential expertise.
3. Integration of Trauma-Sensitive Care and Recovery-Oriented Work
By Simona Karbouniaris PhD
Trauma-sensitive care and recovery-oriented work are key frameworks in modern healthcare, aiming to address the lasting effects of trauma while supporting healing and personal growth. Rooted in the CARe model—which emphasizes connecting, understanding, ensuring, and strengthening—these approaches promote holistic, empathetic, and person-centred care. Trauma-sensitive care goes beyond simply acknowledging trauma; it actively adapts care to meet individual needs, especially in cases of relational trauma like abuse or neglect. Its core principles include safety, trustworthiness, choice, collaboration, and empowerment, all designed to prevent retraumatization and foster recovery. These principles align closely with the CARe model’s relationship-oriented practices, helping care professionals build trust, offer safety, and empower clients in their healing journey.
4. Enabling communities – The importance of communities and social networks for recovery
By Jean Pierre Wilken and Dagmar Narusson
Working with communities is essential for recovery-oriented care, particularly in supporting both functional and social recovery—key aspects of personal recovery. Social recovery focuses on rebuilding meaningful relationships across various life domains, with communities—whether geographic, cultural, or interest-based—playing a central role. Communities provide belonging, support, and access to resources, and their quality depends on bonding (internal connections), bridging (external opportunities), and linking (access to institutional support). The CARe model integrates community work by fostering connections to supportive networks and inclusive environments, or “social niches,” where individuals feel safe, valued, and empowered. Activities like bridge building, reconnecting with social networks, and creating welcoming spaces are central. Peer support is also vital, offering shared experiences that promote hope and empowerment. Community development enhances well-being by strengthening various forms of capital—social, economic, ecological—and relies on engagement, trust, and a shared sense of efficacy. These values align with the CARe model’s core actions: connecting, understanding, ensuring, and strengthening.
5. The CARe Model – A relationship-based approach to recovery
By Jean Pierre Wilken
The CARe Model is a relationship-based approach to mental health recovery, widely used in Europe and Central Asia. Originating in the Netherlands in the 1980s, it focuses on quality of life, empowerment, and social inclusion through four core actions: connecting, understanding, ensuring, and strengthening. The model values personal relationships, holistic care, and community involvement, aiming to support individuals’ autonomy and resilience. It has expanded from psychiatric care to various social support domains, emphasizing a collaborative, humane approach to care. The model was influenced by the psychosocial rehabilitation movement, emphasizing humanizing care and promoting equality between service users, their social networks, and care providers. Initially developed for long-term psychiatric care, the model has since expanded to other domains, including youth work, elderly care, and support for individuals with intellectual disabilities and refugees. The CARe Model’s holistic approach addresses personal, social, and environmental factors, aiming to build resilience, autonomy, and positive social roles. Through collaboration and community involvement, it fosters sustainable recovery, advocating a comprehensive, humane approach to care.